Abstract
Objective
To analyze the cytogenetic abnormalities of a large cohort of consecutive pediatric Acute Myeloid Leukemia (AML) patients, treated on a uniform protocol.
Design
Review of case records.
Setting
Pediatric Cancer Center of tertiary care hospital between June 2003 and June 2016.
Participants
617 consecutive de novo pediatric AML patients were screened and 472 patients were found eligible. Eligibility criteria included non M3 patients, successful cytogenetic profile and availability of complete records
Main outcome measure
Cytogenetic profile.
Results
Gum-hypertropy, chloromas and rate of complete remission were significantly different between European Leukemia Network classification (ELN) cytogenetic risk groups (P<0.01). t (8;21) (141, 29.8%), loss of Y chromosome (61,12.9%) and trisomy 8 (39, 8.3%) were the most common abnormalities. Among the chromosomal gains, trisomy 8 and trisomy 21 (both P<0.01) were significantly different among the three ELN risk groups. Among the chromosome losses, monosomy 5, 7 (both P<0.01) and 9 (P=0.03), loss of X and loss of Y (both P<0.01) were statistically different amongst three cytogenetic risk groups. Event-free survival (P<0.01) and overall survival (P<0.01) were found to be significantly different among the three risk groups.
Conclusions
The higher frequency of t (8; 21) and its association with chloroma in Indian pediatric patients is different from other studies around the world.
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References
Byrd JC, Mrózek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC, et al. Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: Results from Cancer and Leukemia Group B (CALGB 8461). Blood. 2002;100:4325–36.
Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129:424–47.
Avni B, Koren-Michowitz M. Myeloid sarcoma: current approach and therapeutic options. Ther Adv Hematol. 2011;2:309–16.
Nakase K, Bradstock K, Sartor M, Gottlieb D, Byth K, Kita K, et al. Geographic heterogeneity of cellular characteristics of acute myeloid leukemia: A comparative study of Australian and Japanese adult cases. Leukemia. 2000;14:163–8.
Shaffer LG, McGowan-Jordan J, Schmid M, editors. An international system for human cytogenetic nomenclature (ISCN). Basel: Karger; 2013. p. 88–95.
Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–405.
Mrózek K, Marcucci G, Nicolet D, Maharry KS, Becker H, Whitman SP, et al. Prognostic significance of the European leukemia net standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol. 2012;30:4515–23.
Mrózek K. Cytogenetic, molecular genetic and clinical characteristics of acute myeloid leukemia with a complex karyotype. Semin Oncol. 2008;35:365–77.
Sharawat SK, Raina V, Kumar L, Sharma A, Bakhshi R, Vishnubhatla S, et al. High fms-like tyrosine kinase-3 (FLT3) receptor surface expression predicts poor outcome in FLT3 internal tandem duplication (ITD) negative patients in adult acute myeloid leukaemia: A prospective pilot study from India. Indian J Med Res. 2016;143:11–6.
Chopra A, Soni S, Pati H, Kumar D, Diwedi R, Verma D, et al. Nucleophosmin mutation analysis in acute myeloid leukaemia: Immunohistochemistry as a surrogate for molecular techniques. Indian J Med Res. 2016;143:763–68.
O’Donnell MR, Tallman MS, Abboud CN, Altman JK, Appelbaum FR, Arber DA, et al. Acute Myeloid Leukemia, Version 3.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2017;15:926–57.
Grimwade D, Walker H, Harrison G, Oliver F, Chatters S, Harrison CJ, et al. The predictive value of hierarchical cytogenetic classification in older adults with acute myeloid leukemia (AML): Analysis of 1065 patients entered into the United Kingdom Medical Research Council AML11 trial. Blood. 2001;98:1312–20.
Enjeti AK, Tien SL, Sivaswaren CR. Cytogenetic abnormalities in de novo acute myeloid leukemia in adults: Relation to morphology, age, sex and ethnicity-a single center study from Singapore. Hematol J. 2004;5:419–25.
Bacher U, Kern W, Schnittger S, Hiddemann W, Schoch C, Haferlach T. Further correlations of morphology according to FAB and WHO classification to cytogenetics in de novo acute myeloid leukemia: A study on 2,235 patients. Ann Hematol. 2005;84:785–91.
Cheng Y, Wang Y, Wang H, Chen Z, Lou J, Xu H, et al. Cytogenetic profile of de novo acute myeloid leukemia: A study based on 1432 patients in a single institution of China. Leukemia. 2009;23:1801–6.
So CC, Wan TS, Chow JL, Hui KC, Choi WW, Lam CC, et al. A single-center cytogenetic study of 629 Chinese patients with de novo acute myeloid leukemia-evidence of major ethnic differences and a high prevalence of acute promyelocytic leukemia in Chinese patients. Cancer Genet. 2011;204:430–8.
Li X, Li X, Xie W, Hu Y, Li J, Du W, et al. Comprehensive profile of cytogenetics in 2308 Chinese children and adults with de novo acute myeloid leukemia. Blood Cells Mol Dis. 2012;49:107–13.
Amare PK, Jain H, Kabre S, Deshpande Y, Pawar P, Banavali S, et al. Cytogenetic profile in 7209 Indian patients with de novo Acute Leukemia: A single center study from India. J Cancer Ther. 2016;7:530–44.
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Tyagi, A., Pramanik, R., Chaudhary, S. et al. Cytogenetic Profiles of 472 Indian Children with Acute Myeloid Leukemia. Indian Pediatr 55, 469–473 (2018). https://doi.org/10.1007/s13312-018-1335-z
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DOI: https://doi.org/10.1007/s13312-018-1335-z